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Sample Grant Application - NIAID - National Institutes of Health

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Principal Investigator/Program Director (Last, first, middle): Dow, Steven, W<br />

1. Project Director / Principal Investigator (PD/PI)<br />

Prefix: Dr. * First Name: Steven<br />

Middle Name: W<br />

* Last Name: Dow<br />

Suffix:<br />

2. Human Subjects<br />

Clinical Trial?<br />

PHS 398 Cover Page Supplement OMB Number: 0925-0001<br />

No Yes<br />

* Agency-Defined Phase III Clinical Trial? No Yes<br />

3. Applicant Organization Contact<br />

Person to be contacted on matters involving this application<br />

Prefix: * First Name: Christine<br />

Middle Name:<br />

* Last Name: Getzelman<br />

Suffix:<br />

* Phone Number: Fax Number:<br />

Email:<br />

* Title: Senior Research Administrator<br />

* Street1: 601 S. Howes<br />

Street2:<br />

* City: Fort Collins<br />

County/Parish:<br />

* State:<br />

Province:<br />

CO: Colorado<br />

* Country: USA: UNITED STATES * Zip / Postal Code: 80523-2002<br />

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Clinical Trial & HESC Page 23<br />

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